Nomogram-Based Prediction of Survival in Stage IV Nasopharyngeal Carcinoma: A Retrospective Single-Center Study

<b>Background/Objectives</b>: To assess the pretreatment and posttreatment clinical factors associated with the rate of survival at 1, 3, and 5 years in stage IV nasopharyngeal carcinoma (NPC) patients. <b>Methods</b>: Clinicopathological characteristics of 61 Stage IV NPC pa...

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Main Authors: Peng Yeh, Chih-Ming Chang, Li-Jen Liao, Chia-Yun Wu, Chen-Hsi Hsieh, Pei-Wei Shueng, Po-Wen Cheng, Wu-Chia Lo
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/11/1309
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author Peng Yeh
Chih-Ming Chang
Li-Jen Liao
Chia-Yun Wu
Chen-Hsi Hsieh
Pei-Wei Shueng
Po-Wen Cheng
Wu-Chia Lo
author_facet Peng Yeh
Chih-Ming Chang
Li-Jen Liao
Chia-Yun Wu
Chen-Hsi Hsieh
Pei-Wei Shueng
Po-Wen Cheng
Wu-Chia Lo
author_sort Peng Yeh
collection DOAJ
description <b>Background/Objectives</b>: To assess the pretreatment and posttreatment clinical factors associated with the rate of survival at 1, 3, and 5 years in stage IV nasopharyngeal carcinoma (NPC) patients. <b>Methods</b>: Clinicopathological characteristics of 61 Stage IV NPC patients diagnosed between 2008 and 2022 in a single tertiary medical center were retrospectively reviewed. Univariate and multivariate analyses were performed to evaluate the prognostic factors associated with overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). A nomogram was developed to forecast DSS. <b>Results</b>: The OS at 1-year, 3-year, and 5-year were 93%, 70%, and 57%, while the DSS at 1-year, 3-year, and 5-year were 93%, 73%, and 58%, whereas the DFS at 1-year, 3-year, and 5-year were 51%, 44%, and 41%, respectively. In multivariate analyses, posttreatment body mass index (BMI) < 21.6 kg/m<sup>2</sup> (hazard ratio [HR] 2.717, 95% confidence interval [CI] 1.248–5.917, <i>p</i> = 0.012) was an independent indicator for worsened OS. Posttreatment BMI < 21.6 kg/m<sup>2</sup> (HR 3.003, 95% CI 1.340–6.757, <i>p</i> = 0.008) and pretreatment systemic inflammation response index (SIRI) ≥ 125 (HR 2.841, 95% CI 1.256–6.429, <i>p</i> = 0.012) were independent indicators for worsened DSS. Posttreatment BMI < 21.6 kg/m<sup>2</sup> (HR 3.650, 95% CI 1.757–7.576, <i>p</i> = 0.001), change in BMI < −1.93 kg/m<sup>2</sup> (HR 3.731, 95% CI 1.642–8.475, <i>p</i> = 0.002), and pretreatment SIRI ≥ 125 (HR 3.541, 95% CI 1.717–7.304, <i>p</i> = 0.001) were independent indicators for worsened DFS. A nomogram was created to predict DSS using posttreatment BMI and pretreatment SIRI. <b>Conclusions</b>: Associations with survival were observed between posttreatment BMI and OS, DSS, and DFS; pretreatment SIRI and DSS/DFS; and changes in BMI and DFS among patients with stage IV NPC. The developed nomogram aids in survival prediction.
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spelling doaj-art-c026c5845f0f45a2a3aeee2a4cabc1be2025-08-20T02:32:57ZengMDPI AGDiagnostics2075-44182025-05-011511130910.3390/diagnostics15111309Nomogram-Based Prediction of Survival in Stage IV Nasopharyngeal Carcinoma: A Retrospective Single-Center StudyPeng Yeh0Chih-Ming Chang1Li-Jen Liao2Chia-Yun Wu3Chen-Hsi Hsieh4Pei-Wei Shueng5Po-Wen Cheng6Wu-Chia Lo7Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City 220216, TaiwanDepartment of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City 220216, TaiwanDepartment of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City 220216, TaiwanHead and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City 220216, TaiwanHead and Neck Cancer Surveillance and Research Study Group, Far Eastern Memorial Hospital, New Taipei City 220216, TaiwanDivision of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 220216, TaiwanDepartment of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City 220216, TaiwanDepartment of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan<b>Background/Objectives</b>: To assess the pretreatment and posttreatment clinical factors associated with the rate of survival at 1, 3, and 5 years in stage IV nasopharyngeal carcinoma (NPC) patients. <b>Methods</b>: Clinicopathological characteristics of 61 Stage IV NPC patients diagnosed between 2008 and 2022 in a single tertiary medical center were retrospectively reviewed. Univariate and multivariate analyses were performed to evaluate the prognostic factors associated with overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). A nomogram was developed to forecast DSS. <b>Results</b>: The OS at 1-year, 3-year, and 5-year were 93%, 70%, and 57%, while the DSS at 1-year, 3-year, and 5-year were 93%, 73%, and 58%, whereas the DFS at 1-year, 3-year, and 5-year were 51%, 44%, and 41%, respectively. In multivariate analyses, posttreatment body mass index (BMI) < 21.6 kg/m<sup>2</sup> (hazard ratio [HR] 2.717, 95% confidence interval [CI] 1.248–5.917, <i>p</i> = 0.012) was an independent indicator for worsened OS. Posttreatment BMI < 21.6 kg/m<sup>2</sup> (HR 3.003, 95% CI 1.340–6.757, <i>p</i> = 0.008) and pretreatment systemic inflammation response index (SIRI) ≥ 125 (HR 2.841, 95% CI 1.256–6.429, <i>p</i> = 0.012) were independent indicators for worsened DSS. Posttreatment BMI < 21.6 kg/m<sup>2</sup> (HR 3.650, 95% CI 1.757–7.576, <i>p</i> = 0.001), change in BMI < −1.93 kg/m<sup>2</sup> (HR 3.731, 95% CI 1.642–8.475, <i>p</i> = 0.002), and pretreatment SIRI ≥ 125 (HR 3.541, 95% CI 1.717–7.304, <i>p</i> = 0.001) were independent indicators for worsened DFS. A nomogram was created to predict DSS using posttreatment BMI and pretreatment SIRI. <b>Conclusions</b>: Associations with survival were observed between posttreatment BMI and OS, DSS, and DFS; pretreatment SIRI and DSS/DFS; and changes in BMI and DFS among patients with stage IV NPC. The developed nomogram aids in survival prediction.https://www.mdpi.com/2075-4418/15/11/1309nasopharyngeal carcinoma (NPC)nomogrambody mass index (BMI)systemic inflammation response index (SIRI)systemic immune inflammation (SII)
spellingShingle Peng Yeh
Chih-Ming Chang
Li-Jen Liao
Chia-Yun Wu
Chen-Hsi Hsieh
Pei-Wei Shueng
Po-Wen Cheng
Wu-Chia Lo
Nomogram-Based Prediction of Survival in Stage IV Nasopharyngeal Carcinoma: A Retrospective Single-Center Study
Diagnostics
nasopharyngeal carcinoma (NPC)
nomogram
body mass index (BMI)
systemic inflammation response index (SIRI)
systemic immune inflammation (SII)
title Nomogram-Based Prediction of Survival in Stage IV Nasopharyngeal Carcinoma: A Retrospective Single-Center Study
title_full Nomogram-Based Prediction of Survival in Stage IV Nasopharyngeal Carcinoma: A Retrospective Single-Center Study
title_fullStr Nomogram-Based Prediction of Survival in Stage IV Nasopharyngeal Carcinoma: A Retrospective Single-Center Study
title_full_unstemmed Nomogram-Based Prediction of Survival in Stage IV Nasopharyngeal Carcinoma: A Retrospective Single-Center Study
title_short Nomogram-Based Prediction of Survival in Stage IV Nasopharyngeal Carcinoma: A Retrospective Single-Center Study
title_sort nomogram based prediction of survival in stage iv nasopharyngeal carcinoma a retrospective single center study
topic nasopharyngeal carcinoma (NPC)
nomogram
body mass index (BMI)
systemic inflammation response index (SIRI)
systemic immune inflammation (SII)
url https://www.mdpi.com/2075-4418/15/11/1309
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